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Full resolution (TIFF) - On this page / på denna sida - II. Race - 6. Racial Characteristics - 2. Biological Susceptibility to Disease
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142 An American Dilemma
are traditionally supposed to be relatively immune, such as scarlet fever
and diabetes. Diseases which are not frequently a cause of death are
reported so badly or are reported for such inadequate samples that it is
almost inevitable that Negroes would appear to be immune to them even
if they were not really so. Such diseases include hookworm, gout, goiter
and skin diseases.
Most of the discussion, however, has been relative to the diseases to
which Negroes may be especially susceptible, because their rates in these
diseases are higher than those for whites. A large number of such diseases
have been recorded by different investigators,^® but we shall consider only
those which are important as causes of death and those for which the
differences between Negroes and whites are large enough to indicate that
they are due to real differences and not to errors in sampling^® or observa-
tion. This narrows our problem down to pellagra, syphilis, nephritis,
tuberculosis, and pneumonia-influenza as important diseases which arc
definitely more prevalent among Negroes than among whites. No one
seems to have advanced the claim that the Negroes higher death rates due
to pellagra, syphilis, or nephritis result from his biological constitution.
The question of innate racial differences seems to have cropped up mainly
with reference to tuberculosis and pneumonia-influenza. Enough facts are
available to indicate that the main reasons for the discrepancy between
Negroes and whites in the incidence of tuberculosis are environmental and
not hereditary:
1. A study made before the Civil War shows that the incidence of
tuberculosis at that time was considerably higher for whites than for
Negroes.^^ A survey made by Dr. Frederick L. HoflFman indicated: “The
opinion of southern physicians who practised among Negroes before the
Civil War was almost unanimous that consumption was less frequent
among the colored population than among the whites.”^® It was only after
Emancipation that the Negro rate jumped high above that of the whites.
2. Negro deaths from tuberculosis have decreased considerably in recent
years as public health facilities have been improved and made more avail-
able to Negroes. Between 1920 and 1933, the rate per ICX),000 population
declined from 344 to 232 in the North, and from 229 to 130 in the South.^®
3. While, since the Civil War, the Negro tuberculosis rate has always
been higher than the white tuberculosis rate, the Negro rate today is lower
than the white rate was a few decades ago.^®
4. In a few unusual communities in Tennessee, where the Negroes have
a higher occupational status than whites, the tuberculosis rates are higher
for whites than for Negroes.^^
There is not so much direct evidence that the higher pneumonia-influenza
rate for Negroes is due to environmental causes. However, other etiological
studies of these allied diseases have not succeeded in finding a strong
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